Anatomy of the Sinus Flashcards

1
Q

what is the airways divided into

A

upper respiratory tract

lower respiratory tract

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2
Q

what divides the upper and lower respiratory tracts

A

the larynx

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3
Q

what is in the upper respiratory airway

A
  • Everything to the top of the layrnx
  • Nasal cavity
  • Nostril
  • Oral cavity
  • Layrnx
  • pharynx
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4
Q

what is in the lower respiratory tract

A
  • Below the larynx
  • right main bronchus
  • left main bronchus
  • right lung
  • left lung
  • diaphrgam
  • Trachea
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5
Q

what is the bony skeleton of the oral cavity made up of

A
  • maxilla and mandible
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6
Q

what has the upper and lower teeth in it

A
  • maxilla has the upper teeth

- mandible has the lower teeth

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7
Q

what is the roof made out of

A
  • it is made out of a hard palate
  • 2/3 anteriorly is the maxilla
  • 1/3 posterior is the palatine bone
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8
Q

what does the oral cavity proper hold

A

holds the tongue

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9
Q

what is the vesitbual

A

this is the space between the lips and tongue

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10
Q

what sensation do you feel in the mouth

A

sensation mimics the sensation across the skin in front of it

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11
Q

what is the name of the ring at the back of the oral cavity

A

waldaers ring

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12
Q

what is waldaers ring

A
  • there is a 360 degree ring called welders ring surrounding the oral cavity of lymphoid tissue, this is rich in lymphocytes and APC and drains foreign pathogens in the oral cavity
  • where tonsils re held
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13
Q

what is tonsillitis caused by

A
  • bacteria causes 1/3 of cases

- caused by strep bacteria such as S. Pyogenes, S. Aureus, and M. Catarrhalis

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14
Q

what is the function of the nasal cavity

A
  • warms and dehumidifies inspired air
  • removes and traps pathogens from inspired air - lined with goblet cells and ciliated epithelium
  • sense of smell
  • drains paranasal sinuses and lacrimal ducts
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15
Q

what is the vestibule

A
  • the entrance point of the nose
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16
Q

what is the nasal cavity made up of

A

Conchae

  • Superior conchae
  • Superior meatus
  • Middle conchae
  • Middle meatus
  • Inferiror conchae – own bone
  • Inferior meatus
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17
Q

what is the function of the conchae

A
  • Lined in respiratory epitehlium, these increase surface area to body ratio to ensure optimum amount of inspired air to be filtered
  • Makes air tuberlent and slows down the process of inspired air thereofre it stays for longer in the nasal cavity so can get warmer for longer and dehumidiefed for longer and filtered for longer
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18
Q

what innervates the nasal cavity

A

dual olfactory (CNI) - it controls the sense of smell

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19
Q

where does the oflactory nerves run

A
  • It is a continuation of your cerberal cortex
  • The olfactory nerves run inferiorly from the olfactory bulb, though the perforated cribiform plate of the ethmoid bone to enter the nasal cavity
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20
Q

what are the paranasal sinuses

A
  • extensions of the nasal cavity that form during the early years of life
  • they are hollow spaces within the frontal, sphenoid, ethmoid and maxillary bones
  • they are lined by mucous membrane and they all drain into the nose
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21
Q

how many paranasal sinuses are there

A

4 paired paranasal sinuses

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22
Q

what do the paranasal sinuses drain in to

A

all linked to the nasal cavity therefore they all drain back into the nasal cavity

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23
Q

what are the 4 paranasal sinuses

A
  1. Frontal – 2 paried
  2. Ethmoid – 3 paried
  3. Sphenoid – 2 paried
  4. Maxiallary – 2 paired
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24
Q

what is the function of the paranasal sinuses

A
  • Lined with the same respriatory epithelium – mucus – filter pathogens
  • Warm air
  • Reduce the weight of the head to make it lighter to carry
  • The sound that is admitted from the larynx in the vocal cord goes upt ot he head and the paranasal sinuses make the sound travel furhter
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25
Q

what happens when inflammation goes into the paranasal sinuses

A
  • inflammation can spread to any of the paranasal sinuses as they are all interlinked at the nasal cavity
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26
Q

How do the sinuses drain back into the nasal cavity

A
  • Frontal sinuses - Frontonasal duct to semilunar hiatus on the lateral wall.
  • Ethmoid sinuses  3 sinuses:
  • Anterior ethmoid sinus – semilunar hiatus
  • Middle ethmoid sinus – Ethmoid bulla
  • Posterior ethmoid sinus – Superior meatus

Sphenoid sinuses - Drains to the roof of the nasal cavity

Maxillary sinuses - semilunar hiatus

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27
Q

what is the pharynx

A
  • it is a muscular tube that connects the oral and nasal cavities to the trachea and oesophagus
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28
Q

what is the shape of the pharynx and the propulsion of food into the oesophagus controlled by

A
  • 2 sets of pharyngeal muscles - (circular and longitudinal)
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29
Q

what are the two sets of muscles in the pharynx

A
  • circular and longitudinal
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30
Q

what is the pharynx part of

A

respiratory tract and GI tract

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31
Q

what is the pharynx divided into

A
  • Nasopharynx – back of the nasal cavity
  • Oropharynx – back of oral cavity
  • Largenopharynx – top of the larynx,
32
Q

what is the innervation of the pharynx

A
  • Nasopharynx trigenryal nerve
  • Oraphranyx – glossphageal nerve
  • Laryenopharynx – vagus
33
Q

what are the circular pharyngeal muscles

A
  • Superior constrictior
  • Middle constrictor
  • Inferior constrictor
34
Q

what is the role of circular pharyngeal muscles

A
  • contract to propel food backwards into the oesophagus
35
Q

what is the role of the longitudinal pharyngeal muscles

A
  • Closes of the layrnx to make sure food doesn’t go down the wrong way during swallowing
36
Q

what is the longitudinal muscles divided into

A
  • superior constricted

- inferior constricted

37
Q

what is the innervation of the longitudinal and circular pharyngeal muscles

A

They are all innevrated by the vagus nerve excpet the styopharngeous which is supplied by the glasopharyngeal nerve

38
Q

what is the larynx

A
  • it is the connection between the upper and lower respiratory tract
39
Q

what is the function of the larynx

A
  • Protection of airway during eating

- Producing sounds (phonation)

40
Q

what does the epiglottis do

A

flaps back to seal the larygenal during swallowing to make sure nothing is swallowed down the wrong way

41
Q

where is the larynx

A
  • anterior at the neck C3-C6

- continuous inferiorly with trachea

42
Q

what are the 9 cartilages divided into in the larynx

A

3 unpaired

3 paired

43
Q

what are the 3 unpaired cartilages

A
  • epiglottis
  • thyroid
  • cricoid
44
Q

what are the 3 paired cartilages

A
  • arytenoid
  • corniculate
  • cuneiform
45
Q

describe what the epiglottis is attached to

A

attahces anteriorioly to the stalk to the thyroid that sits underneath it, attahced to the thyroid cartilage

46
Q

describe the thyroid cartilage

A

prominent at the front, at the back it opens into an open book configuration

47
Q

describe the cricoid cartilage

A

only point in the respiratory tract where there is a 360 degree ring of cartilage

48
Q

what do the arytenoids do and what are they attached to

A
  • sound production
  • sit on top of the critoicoid cartilage, joined via ligament anteriorly to the thyroid cartilage, these ligaments are the vocal cords
49
Q

describe what the cuneiform is attached to

A

anterior to conriculate

50
Q

what is the blood supply to the larynx

A
  • Supplied by Sup. laryngeal artery (ECA) and Inf. Laryngeal artery (thyrocervical trunk)
51
Q

what are the ligaments in the larynx

A
  • Thyrohyoid ligament – between thyroid and hyloid bone
  • Cricothyroid ligament – between thryoid to criocoid
  • Cricotracheal ligament – between criocoid tracheal
52
Q

what is the vocal ligament

A
  • it is an avascular moist ligament that is covered in mucus membrane that forms a tight opening to the larynx below
53
Q

what is the rima glottides

A
  • space between vocal folds and glottidis folds that seals the larynx opening
54
Q

what controls the movement of the vocal folds

A
  • arytenoid cartilages - this makes the rima glottids space making it smaller or bigger, producing sound
55
Q

define phonation

A

– movement of arytenoid muscles that move the vocal sounds around and produces the high frequency that we here as sound

56
Q

what are the muscles that move the arytenoids and control phonation

A
  • Arytenoid muscles (transverse & oblique)
  • Crico-arytenoid muscles (lateral & posterior)
  • Thyro-arytenoid muscle
  • Vocalis
57
Q

what causes the pitch of sound

A
  • not the arytenoids muscles
  • the cricothyroid muscles does this, it controls the pitch changing from a low pitch to a high pitch by tilting the arytenoid cartilages up and down, this causes the pitch of phonation to change
58
Q

what do the extrinsic muscles do

A
  • close laryngeal inlet when swallowing so you do not have aspiration
59
Q

what is the extrinsic muscles divided into

A

suprahyoid group

infrahyoid group

60
Q

what is the innervation for the intrinsic muscles of the larynx

A
  • originates from the vagus nerve
  • recurrent laryngeal nerve
  • superior laryngeal nerve- divides into the internal and external laryngeal nerve
61
Q

what does the internal layrgensl nerve supply

A
  • sensory

- sensory innervation to areas above the vocal cords

62
Q

what does the superior laryngeal nerve divide into

A
  • internal larygenal nerve - sensory

- external laryngeal nerve - motor - controls pitch

63
Q

what does the external laryngeal nerve supply

A
  • goes to muscle that changes the pitch
  • motor to cricothyoid
  • controls pitch
64
Q

what does the recurrent laryngeal supply

A
  • motor to all intrinsic muscles except cricothryoid
  • controls phonation
  • sensory to innervation area below vocal cords
65
Q

what happens if there is a lesion on the recurrent laryngeal nerves

A
  • vocal cord paralysis - inability to abduct laterally

- causes hoarseness, aphonia, stridor

66
Q

what happens of there is a lesson on the external laryngeal nerve

A
  • cricothryoid paralysis
  • prevents higher pitched phonation
  • causes a weak voice, low pitch, easily tires, reduced range
67
Q

what are the subclavian artery branches

A
  • Dorsal scapular artery
  • Costocervical trunk
  • Thyocervical trunk – inferior larygenal artery
  • Internal throacic artery
  • Vertebral artery
68
Q

the superior laryngeal and inferior laryngeal …

A

anatomise in the middle

69
Q

where does the superior laryngeal come from

A
  • comes from the superior thyroid artery which comes from the external carotid artery
70
Q

where does the inferior laryngeal come from

A

comes from the inferior thyroid artery which comes rom the thyrocervical trunk

71
Q

describe what the external carotid artery divides into

A
  • Superior thryoid artery – superior larygenal artery
  • Asecodning pharyngeal artery
  • Lingual arteyr
  • Facial artery
  • Occipital artyer
  • Posterior auricular arteyr
  • Maxiallary artery
  • Superficial temopar artery
    Some anatomist like freaking out poor medical students
72
Q

what is the normal way to incubate an airway

A
  • endotracheal incubation
73
Q

how do you do an endotracheal incubation

A
  • Insert of plastic tube via mouth, past vocal cords into the trachea
  • Allows manipulation of ventilation and oxygenation
74
Q

what patients do you use an endotracheal incubation on

A
  • Anaesthetised patients

- Critcally unwell patietns umable to protect own airway

75
Q

what happens if you cannot incubate

A

cricothyroidotmy

76
Q

how do you to a cricothyroidotmy

A
  1. Palpate laryngeal prominence of thyroid cartilage
  2. Work inferiorly to palpate cricoid cartilage to ascertain cricothyroid ligament
  3. Make vertical incision from mid thyroid cartilage to superior aspect of cricoid cartilage
  4. Puncture through cricothyroid membrane with horizontal scalpel
  5. Insert airway